138 Non-anginal chest pain: not as benign as we would like to believe!

Abstract

Background In the Quick Reference Guide of the clinical guidance 95 (CG95) NICE recommends that chest pain (CP) diagnosed as non-anginal
(NA) should not be investigated for stable angina routinely. In the Full Guidance, it qualifies this statement suggesting
that stable angina should be excluded in patients with NACP unless clinical suspicion is raised based on other aspects of
the history and risk factors. In the chest pain management algorithm, however, it excludes patients with NACP in whom stable
angina is suspected based on history and risk factors. This study was undertaken to assess the outcome of patients attending
rapid access chest pain clinic (RACPC) and diagnosed with NACP who are likely to be discharged without further investigation
as suggested by CG95.

Conclusion 47 (7.6%) patient that are to be discharged without investigation, had significant coronary artery disease. Even with a short
follow-up, 10% of these patients needed medical attention for suspected cardiovascular morbidity. It may be unreasonable to
discharge patients describing NACP especially diabetics.